Department of Physical Therapy, University of Salamanca, Salamanca, Spain.
Clin J Pain. 2013 Jun;29(6):478-86. doi: 10.1097/AJP.0b013e3182652d65.
To identify the presence of myofascial trigger points (TrPs) and pressure pain threshold (PPT) levels in the shoulder muscles of both involved and uninvolved sides in patients with unilateral shoulder impingement syndrome (SIS).
Twenty-seven patients with SIS and 20 matched control patients participated in this study. TrPs of 10 shoulder muscles and 8 PPTs, including tibialis anterior PPT, were assessed.
SIS group showed a greater number of TrPs (t=-2.697; P=0.010) than the control group. The muscles of the uninvolved side of the SIS group also presented some active TrPs. PPTs showed small differences between involved and uninvolved sides of patients with SIS and higher differences between both sides of the SIS group and dominant side of controls although with significant difference only in the supraspinatus PPT (F=3.239; P=0.045). The muscle PPTs of the patients presenting TrPs in each muscle of the involved side were lower than the PPTs of the patients without TrPs in the same muscle for both involved and uninvolved sides with few significant differences.
The high number of TrPs in the involved side of patients with SIS suggests the presence of peripheral sensitization. The results reject the presence of central alterations. Finally, the patients with unilateral SIS may present bilateral deficits related to myofascial pain.
在单侧肩峰下撞击综合征（SIS）患者的患侧和健侧肩部肌肉中，确定肌筋膜触发点（TrP）的存在和压痛阈（PPT）水平。
本研究纳入 27 例 SIS 患者和 20 名匹配的对照组患者。评估了 10 块肩部肌肉和 8 个 PPT，包括胫骨前肌 PPT。
SIS 组的 TrP 数量多于对照组（t=-2.697；P=0.010）。SIS 组健侧肌肉也存在一些活跃的 TrP。SIS 患者患侧和健侧的 PPT 之间存在较小差异，SIS 组两侧和对照组优势侧之间存在较大差异，但仅在冈上肌 PPT 上具有显著差异（F=3.239；P=0.045）。在每个患侧肌肉中存在 TrP 的患者的肌肉 PPT 低于同一肌肉中无 TrP 的患者的 PPT，尽管在患侧和健侧都只有少数具有显著差异。
SIS 患者患侧的大量 TrP 提示存在外周敏化。研究结果排除了中枢改变的存在。最后，单侧 SIS 的患者可能会出现与肌筋膜疼痛相关的双侧缺陷。
